Ralph Frederick Jerome, PT
Individual provider Active NPI Physical Therapist · Mannford, OK
NPI 1992829360 · NPPES record last updated Oct 15, 2021
Key facts
- NPI
- 1992829360
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 2974 (OK)
- Practice address
- 112 Evans Avenue
Mannford, OK 74044 - Phone
- (918) 865-7020
- Fax
- (918) 865-7039
- NPI assigned
- Mar 19, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
112 Evans Ave
Mannford, OK 74044-3152
Phone (918) 865-7020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101209001357 | OK | Practitioner - Physical Therapist in Private Practice | 6103013636 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2974 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Results Therapy Services LLC | Physical Therapist | Current |
Accepting new patients |
Locations
103 Phelps Ave
Mannford, OK 74044
Phone (918) 865-7020
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2974 | OK | Yes |
Addresses
Primary practice location
112 Evans Avenue
Mannford, OK 74044
Mailing address
PO Box 361
Mannford, OK 74044-0361
Phone (918) 865-7020
Other providers in Mannford, OK
- Amy Elizabeth Garner
- Ronald Gerald Glass
- Timber Kay Hammond
- Sarah Higgins
- Tiffany Ann Isaacs
- Ruth Johnson
- Christopher Adam Landy
- Legacy Health and Wellness, LLC.
- Angela Mackey
- Jessie G Mackey
All providers in Mannford, OK · Physical Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.